Malignancy Risk Factors in Female Pelvic Tumors

Abstract

In a patient with a palpable adnexal mass,the optimal diagnostic and therapeutic approach depends on the likelihood that the mass is malignant. It is beneficial for the surgeon to anticipate carcinoma of the ovary before an operation so that adequate procedurescan be planned. Neoplasms of the ovary present an increasing challenge to the physician. (Kurjak & Zalud 1993).

Ovarian cancer,being a disease that presents late and responds poorly to treatment, is the most lethal of the gynaecologic cancers. Primary ovarian cancer is an insidious and intractable disease that may originate from different types of cells. In spite of the intensive efforts to improve treat1,1ent of the established disease with advances in surgical and chemotherapeutic techniques, the overall 5 year survival rates have ranged between 20% and 25% in most studies (Ozols 1992).

So the early detection of ovarian cancer becomes the next focus of efforts to reduce premature death among women. Recent advances in immunological techniques have raised hopes that an ovarian cancer-specific antigen may be identified. One of the most encouraging tumour-associated antigens investigated in relation to ovarian cancer is CA125. However, it is important to recognize the limitations of CA125; although the majority of patients (80%) with ovarian epithelial carcinoma have preoperative CA125 level above 35 U/mL, mucinous. border line and germ cell tumours of the ovary do not consistently produce elevated CA125 levels. In addition some benign disease states are associated with CA125 elevations (Oram & Jacobs 1987).

Ultrasonography is more sensitive than pelvic examination in

detecting ovarian

abnormalities but lacks specificity in

distinguishing benign from malignant ovarian lesions. Combined with CA125 levels. ultrasonography may provide an effective screening